Background Various modalities are under study for prevention and treatment of novel coronavirus. One such modality is use of Hydroxychloroquine/Choloroquine. The objective of survey was to understand the awareness and impact of HCQ/CQ prophylaxis among the health care workers (HCWs) including surgeons and anaesthetists. Methods A web-based, cross-sectional survey was conducted for HCWs globally. Participation was voluntary and con dentiality was maintained by making participants' information anonymous. The questionnaire consisted of 28 items. Data were tabulated in excel, and descriptive statistics were performed. Results Survey was taken by 344 HCWs from all over the world. 98% participants heard about the use of HCQ/CQ prophylaxis against COVID 19 infection. 301 HCWs knew about the side effects of HCQ/CQ. 54 1% participants agree there is not adequate research done. 122 participants took HCQ/CQ prophylaxis. Out of 29 5% participants who received the medicine from hospital under hospital protocol, 66 7% were given medication without baseline investigations and 30 5% HCWs were not even briefed about the drug and its side effects by the hospitals. 36 2% participants developed side effects. 8 7% HCWs were tested for COVID19 out of 344 participants. Conclusion The drug taken by HCWs was without adequate evidence, prior investigations, supervision and followup. Most of the participants self prescribed the drug. No separate guidelines were stated for people who had comorbid conditions. Hospitals neither conducted baseline investigations and nor briefed HCWs about HCQ/CQ. These are some serious concerns we are looking into as who will be answerable in case of adverse events.
Topical corticosteroids (TC) have greatly contributed to the dermatologist's ability to effectively treat several difficult dermatoses. The available range of formulations and potency gives flexibility to treat all groups of patients, different phases of disease, and different anatomic sites. However, the rapid rise in incidence of improper use of these drugs by dermatologists, general physicians, and patients threatens to bring disrepute to the entire group of these amazing drugs. Responsibility to disseminate proper knowledge regarding when, where, and how to use TC both to internists and patients rests primarily with the dermatologist. Benefits of rational and ethical use and the harm of overuse and misuse for nonmedical, specially for cosmetic purposes, should be clearly conveyed before penning a prescription involving TC. Simultaneous efforts to use political, legal, and other institutions to prevent misuse of these drugs by rationing their availability only through proper prescriptions will greatly help the cause. This will hopefully bring down both the extremes of ever increasing cases of steroid-induced dermatoses on one hand and the irrational fears of using TC in well justified indications on the other.
Background:Melasma is an acquired increased pigmentation of the skin, characterized by gray-brown symmetrical patches, mostly in the sun-exposed areas of the skin. The pathogenesis is unknown, but genetic or hormonal influences with UV radiation are important.Aims:Our present research aims to study the clinico-epidemiological pattern and the precipitating or provocation factors in melasma.Materials and Methods:A total of 312 patients were enrolled for the study over a period of one year.Results:The mean age of patients with melasma was 33.45 years, ranging from 14 to 54 years. There was female preponderance with a female to male ratio of approximately 4 : 1. The mean age of onset was 29.99 years, with the youngest and oldest being 11 and 49 years, respectively. The patients sought medical treatment on an average of 3.59 years after appearance of melasma. About 55.12% of our patients reported that their disease exacerbated during sun exposure. Among 250 female patients, 56 reported pregnancy and 46 reported oral contraceptive as the precipitating factors. Only 34 patients had given history of exacerbation of melasma during pregnancy. A positive family history of melasma was observed in 104 (33.33%) patients. Centrofacial was the most common pattern (55.44%) observed in the present study. Wood light examination showed the dermal type being the most common in 54.48% and epidermal and mixed were seen in 21.47% and 24.03% of the cases, respectively. We tried to find an association with endocrinal diseases and observed that 20 of them had hypothyroidism.Conclusion:The exact cause of melasma is unknown. However, many factors have been implicated in the etiopathogenesis of this disorder. Here we try to identify the causative factors and provocation to develop melasma.
Acne Vulgaris is one of the most common skin disorders which dermatologists have to treat. It mainly affect adolescent, though may present at any age. In recent years, due to better understanding of the pathogenesis of acne, new therapeutic modalities and various permutation and combinations have been designed. In topical agents; benzoyl peroxide, antibiotics, retinoids, etc are the mainstay of treatment; can be given in combinations. While systemic therapy includes oral antibiotics, hormonal therapy, and isotretinoin, depending upon the need of patients it has to be selected. Physical treatment in the form of lesion removal, photo-therapy is also helpful in few of them. Since various old and new topical and systemic agents are available to treat acne, it sometime confuse treating dermatologist. To overcome this, panel of physicians and researchers worked together as a global alliance and task force to improve outcomes in acne treatment. They have tried to give consensus recommendation for the treatment of acne. Successful management of acne needs careful selection of anti-acne agents according to clinical presentation and individual patient needs.
Varied clinical presentations are seen with prolonged and continuous use of topical steroids. The treatment of this dermatitis is difficult, requiring complete cessation of the offending steroid, usually done in a tapering fashion.
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